The co-evolution of policy mixes and socio-technical systems: towards a conceptual framework of policy mix feedback in sustainability transitions

Understanding how policymaking processes can influence the rate and direction of socio-technical change towards sustainability is an important, yet underexplored research agenda in the field of sustainability transitions. Some studies have sought to explain how individual policy instruments can influence transitions, and the politics surrounding this process. We argue that such individual policy instruments can cause wider feedback mechanisms that influence not only their own future development, but also other instruments in the same area. Consequently, by extending the scope of analysis to that of a policy mix allows us to account for multiple policy effects on socio-technical change and resultant feedback mechanisms influencing the policy processes that underpin further policy mix change. This paper takes a first step in this regard by combining policy studies and innovation studies literatures to conceptualise the co-evolutionary dynamics of policy mixes and socio-technical systems. We focus on policy processes to help explain how policy mixes influence socio-technical change, and how changes in the socio-technical system also shape the evolution of the policy mix. To do so we draw on insights from the policy feedback literature, and propose a novel conceptual framework. The framework highlights that policy mixes aiming to foster sustainability transitions need to be designed to create incentives for beneficiaries to mobilise further support, while overcoming a number of prevailing challenges which may undermine political support over time. In the paper, we illustrate the framework using the example of the zero carbon homes policy mix in the UK. We conclude with deriving research and policy implications for analysing and designing dynamic policy mixes for sustainability transitions

Realizing General Education: Reconsidering Conceptions and Renewing Practice

General Education is widely touted as an enduring distinctive of higher education in the United States (Association of American Colleges and Universities, [11]; Boyer, [37]; Gaston, [86]; Zakaria, [202]). The notion that undergraduate education demands wide‐ranging knowledge is a hallmark of U.S. college graduates that international educators emulate (Blumenstyk, [25]; Rhodes, [158]; Tsui, [181]). The veracity of this distinct educational vision is supported by the fact that approximately one third of the typically 120 credits required for the bachelor\u27s degree in the United States consist of general education courses (Lattuca & Stark, [120]). Realizing a general education has been understood to be central to achieving higher education\u27s larger purposes, making it a particularly salient concern

Return to Education and the Changing Role of Credentials in the Croatian Labor Market

Wage structure, Earning regression, Return to education, J31, P23, P52,

Challenges faced by nurses in managing pain in a critical care setting

AIM: To explore nurses' challenges in managing pain among ill patients in critical care.BACKGROUND: Pain can lead to many adverse medical consequences and providing pain relief is central to caring for ill patients. Effective pain management is vital since studies show patients admitted to critical care units still suffer from significant levels of acute pain. The effective delivery of care in clinical areas remains a challenge for nurses involved with care which is dynamic and constantly changing in critically ill.DESIGN: Qualitative prospective exploratory design.METHODS: This study employed semi structured interviews with nurses, using critical incident technique. Twenty-one nurses were selected from critical care settings from a large acute teaching health care trust in the UK. A critical incident interview guide was constructed from the literature and used to elicit responses.RESULTS: Framework analysis showed that nurses perceived four main challenges in managing pain namely lack of clinical guidelines, lack of structured pain assessment tool, limited autonomy in decision making and the patient's condition itself.CONCLUSIONS: Nurses' decision making and pain management can influence the quality of care given to critically ill patients. It is important to overcome the clinical problems that are faced when dealing with pain experience.RELEVANCE TO CLINICAL PRACTICE: There is a need for nursing education on pain management. Providing up to date and practical strategies may help to reduce nurses' challenges in managing pain among critically ill patients. Broader autonomy and effective decision making can be seen as beneficial for the nurses besides having a clearer and structured pain management guidelines

Intensivmedizinische Behandlung von Erwachsenen mit angeborenen Herzfehlern

Due to improvements in cardiac surgery and perioperative care the number of adults with congenital heart disease is continuously growing. The perioperative and intensive care management of these patients is a challenge due to the variety of pathologies and surgical options as well as the complex pathophysiology. Many patients develop organ dysfunction with time and many require multiple cardiac operations as well as non-cardiac interventions during adulthood. While these patients are best treated in dedicated tertiary centers that provide a multidisciplinary expertise, basic knowledge of this population is important for everyone involved in acute medical care. This review will discuss some general aspects of adults with congenital heart disease such as pulmonary hypertension, Eisenmenger syndrome, cyanosis, pregnancy and perioperative care, with a special focus on the management of critically ill patients